Organization
LEGACY MOBILE LLC
Active
Other names
Legacy Mobile
Organization subpart
No
Provider details
NPI number
Authorized official
SIMON AMEDAI (FOUNDER)
(480) 349-0813
Entity
Organization
Contact information
Practice address
4327 W MALDONADO RD, LAVEEN, AZ 85339-6227
(480) 349-0813
Mailing address
4327 W MALDONADO RD, LAVEEN, AZ 85339-6227
(480) 349-0813
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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